T Rannio1, J Asikainen1, P Hannonen1, T Yli-Kerttula2, P Ekman2, L Pirilä3, L Kuusalo3, M Mali3, M Puurtinen-Vilkki3, S Kortelainen3, J Paltta3, K Taimen3, M Kauppi4, K Laiho4, S Nyrhinen4, H Mäkinen5, P Isomäki5, T Uotila5, K Aaltonen6, H Kautiainen7, T Sokka8. 1. a Department of Rheumatology , Central Hospital of Central Finland , Jyväskylä , Finland. 2. b Department of Rheumatology , Satakunta Central Hospital , Rauma , Finland. 3. c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland. 4. d Department of Rheumatology , Päijät-Häme Central Hospital , Lahti , Finland. 5. e Department of Rheumatology , Tampere University Hospital , Tampere , Finland. 6. f Faculty of Pharmacy, University of Helsinki , Helsinki , Finland. 7. g Department of General Practice and Primary Health Care , University of Helsinki , Helsinki , Finland. 8. h Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.
Abstract
OBJECTIVE: To assess what proportion of patients with disease-modifying anti-rheumatic drug (DMARD)-naïve early rheumatoid arthritis (ERA) reach 28-joint Disease Activity Score (DAS28) remission over 1 year, and remission variability across clinics in Finland. METHOD: Patients with DMARD-naïve newly diagnosed inflammatory arthritis were recruited. The proportion of patients in 28-joint Disease Activity Score with three variables (DAS28-3) remission was compared across sites. Repeated measures were analysed using a mixed models approach with appropriate distribution and link function. RESULTS: In total, 611 patients were recruited at five sites: 67% were female; the mean (sd) age was 57 (16) years; 71% and 68% were positive for rheumatoid factor and anti-cyclic citrullinated peptides, respectively; and 23% had radiographic erosions. A total of 506 (83%) fulfilled the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria for rheumatoid arthritis for further analyses. DAS28-3 remission was met by 68% and 75% at 3 and 12 months, respectively. The clinical site had no effect on remission when adjusted for confounders. At baseline, 68% used methotrexate-based combination therapy, and 31% used triple therapy with methotrexate, hydroxychloroquine, and sulphasalazine (the Fin-RACo regimen). In multivariate analysis, the only independent predictors of DAS28-3 remission at 12 months were lower baseline DAS28-3 and triple therapy as the initial treatment. CONCLUSION: Three out of four DMARD-naïve ERA patients in Finland are in remission during the first year from the diagnosis. High remission rates were achieved for most patients with the use of conventional synthetic DMARDs in combination. Treatment of DMARD-naïve ERA patients with the FIN-RACo regimen is a predictor of DAS28-3 remission in real-life rheumatology settings.
OBJECTIVE: To assess what proportion of patients with disease-modifying anti-rheumatic drug (DMARD)-naïve early rheumatoid arthritis (ERA) reach 28-joint Disease Activity Score (DAS28) remission over 1 year, and remission variability across clinics in Finland. METHOD:Patients with DMARD-naïve newly diagnosed inflammatory arthritis were recruited. The proportion of patients in 28-joint Disease Activity Score with three variables (DAS28-3) remission was compared across sites. Repeated measures were analysed using a mixed models approach with appropriate distribution and link function. RESULTS: In total, 611 patients were recruited at five sites: 67% were female; the mean (sd) age was 57 (16) years; 71% and 68% were positive for rheumatoid factor and anti-cyclic citrullinated peptides, respectively; and 23% had radiographic erosions. A total of 506 (83%) fulfilled the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria for rheumatoid arthritis for further analyses. DAS28-3 remission was met by 68% and 75% at 3 and 12 months, respectively. The clinical site had no effect on remission when adjusted for confounders. At baseline, 68% used methotrexate-based combination therapy, and 31% used triple therapy with methotrexate, hydroxychloroquine, and sulphasalazine (the Fin-RACo regimen). In multivariate analysis, the only independent predictors of DAS28-3 remission at 12 months were lower baseline DAS28-3 and triple therapy as the initial treatment. CONCLUSION: Three out of four DMARD-naïve ERA patients in Finland are in remission during the first year from the diagnosis. High remission rates were achieved for most patients with the use of conventional synthetic DMARDs in combination. Treatment of DMARD-naïve ERA patients with the FIN-RACo regimen is a predictor of DAS28-3 remission in real-life rheumatology settings.
Authors: Laura Kuusalo; Kari Puolakka; Hannu Kautiainen; Anna Karjalainen; Timo Malmi; Leena Paimela; Marjatta Leirisalo-Repo; Vappu Rantalaiho Journal: Clin Rheumatol Date: 2017-12-26 Impact factor: 2.980
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Authors: M M A Verhoeven; P M J Welsing; J W J Bijlsma; J M van Laar; F P J G Lafeber; J Tekstra; J W G Jacobs Journal: Curr Rheumatol Rep Date: 2019-04-23 Impact factor: 4.592